The 2013-2014 flu season had a mild start but since late December, cases have been going up each week.

A new report from the New York State Department of Health also shows that young and middle aged people age 18 to 49 are showing the highest percentage of infection.

"The majority of the virus that is circulating is this 2009 H1N1 and the characteristic of that virus is that it affects a younger than normal population," said Faxon St. Luke's Healthcare direction of infection prevention Heather Bernard.

Bernard says this flu season shows why everyone needs to be protected. Three adults in Onondaga county and one in Madison county have died from the flu this year. Typically it's the elderly and very young children who are at the highest risk -- but this H1N1 influenza strain is different.

"There was a similar strain of this H1N1 circulating many many years ago and so that the elderly population, those over 65 were exposed to it and have some built up immunity," said Bernard.

Doctors say that the best possible protection is a flu shot and are frustrated by people like Frank Colluccio from Utica who refuses to get one.

"Everyone I know who gets the flu shot gets the flu - and I don't get sick that often," said Colluccio.

Teresa Staring also didn't get a flu shot this year and Friday was the first time she left her house after five days with the flu.